Immunization Adherence in Children With Sickle Cell Disease: A Single-Institution Experience

Area of Science:

• Pediatric Hematology
• Immunology
• Public Health

Background:

• Advisory Committee on Immunization Practices (ACIP) recommends specific immunizations for individuals with functional asplenia.
• Children with sickle cell disease, a common cause of functional asplenia, exhibit low adherence to these recommended vaccines.
• Assessing adherence and registry use is vital for improving preventive care in this vulnerable population.

Purpose of the Study:

• To evaluate immunization adherence to ACIP guidelines for children with sickle cell disease.
• To assess the utilization of the Kentucky Immunization Registry (KYIR) by healthcare providers for this patient group.
• To identify specific vaccines with low adherence rates in functionally asplenic children.

Main Methods:

• Retrospective chart review of 107 children (ages 2-18) with sickle cell disease at a single institution.
• Immunization histories were compiled from electronic medical records (EMRs), the KYIR, and primary care physician records.
• Patients were categorized based on the completeness of their immunization history in the KYIR.

Main Results:

• Overall adherence to the ACIP-recommended immunization schedule was low at 6%.
• High compliance was observed for Haemophilus influenzae type B vaccine, but rates for meningococcal and pneumococcal vaccines varied (25%-77%).
• Meningococcal B vaccine showed the lowest adherence rate (25%), and only 3 patients had complete immunization histories in the KYIR.

Conclusions:

• Children with sickle cell disease demonstrate poor adherence to recommended immunizations for functional asplenia.
• Quality improvement initiatives are needed to enhance vaccination rates and improve the documentation of immunization records in the KYIR.
• Targeted interventions may be necessary to address low adherence for specific vaccines like meningococcal B.